The dangers of EDs . . . a recent student poll reveals a painful reality
Madison, WI – When asked to select one word that best describes their eating disorder, UW-Madison students chose these: Obsessed. Anxious. Stress. Pain. Restrictions.
BODY IMAGE. Eating Disorders (ED).
According to the poll, “body image,” was the most selected option - not a total surprise in a social media immersed visual world filled with teens and adults trying to discover themselves.
Everywhere we turn media is bombarding us with false images of men and women. People will go to extremes to become the “ideal” man or woman -- sometimes to the extent that they jeopardize their health.
Paula Cody, an Assistant Professor of Pediatrics in the Division of Adolescent Medicine in the UW-Madison School of Medicine and Public Health, delivers a seminar on modern day eating disorders where she allows us into the lives of her patients by revealing the dark reality of their illnesses.
Upon years of research and work in the hospital, Cody identifies 5 main eating disorders that deserve public attention. Moreover, she takes us down a path where we come face to face with these patients,and their struggle to develop healthy eating patterns while developing normalcy in their lives.
“I hear people say, ‘I weigh 175 but my goal weight is 100 because that’s how much the model weighs," she explains. “It is a terrible trend amongst adolescents and young adults today.”
To Cody, eating disorders are demons that trap you in your own body, without control, feeling helpless, alone and guilty. They are crippling mental illnesses.
“Eating disorders are a significant mental health disease that just happens to have medical and physical complications.” This is why Cody gathered a team of dietitians, psychiatrists and medical professionals to target all aspects of the illness.
Like any mental illness, each case is unique and most often tricky to diagnose. Finding the right treatment along with treatment timing is imperative to successful rehabilitation, so Cody recommends seeking help sooner rather than later.
Cody argues that if the community is aware of the differences between eating disorders, people can seek treatment for their suffering loved ones.
To help, she highlights 5 of the most common yet deadly eating disorders, acknowledged by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
The first, Anorexia nervosa, turns victims into the living dead: sallow cheeks, bony legs and protruding ribs. To be diagnosed with anorexia, the individual must have a low and unnatural body weight, a fear of gaining weight, and some form of body image disturbance.
Body image disturbance, commonly known as body dysmorphia, is an unfortunate phenomena many experience.
Have you ever looked into a mirror and felt inadequate? Have you ever compared yourself to that one mom, student, or coworker who just always has it together? Have you ever been called “beautiful” or “handsome”and outright denied it?
Cody illustrates,“For those with Anorexia Nervosa look into the mirror and see someone who is fat when everyone sees them as skinny. Their entire self-worth is determined by the number on the scale.”
Bulimia nervosa is quite opposite from anorexia but equally as deadly. Bulimia is characterized by the binge, the infamous compensatory mechanism, and the binge-purge cycle.
“The binge” is more than deciding to go for a 2nd slice of pumpkin pie at Thanksgiving.
Imagine sitting in front of your fridge, clearing away shelf by shelf, unable to stop yourself from shoveling food into your mouth despite feeling as if your stomach is going to burst. Staring at an empty fridge, unable to get up due to your stomach pain, all you feel is shame and disgust.
This is the binge.
“I have a bulimia patient,” says Cody, “who consumes 7000 calories in one sitting. She’d eat 3-4 McDonald’s meals, a box of donuts, a pint of ice cream, a jar of peanut butter, and a bunch of pastries.”
The compensatory mechanism, or the “purge,” is a behavior that rationalizes the guilt that accompanies every binge; it’s the part of the story where patients try coping with the large amount of calorie intake by self-induced vomiting, abuse of laxatives or diaretics, over-exercising, body-cleanses and many more restrictions.
Patients of Bulimia are trapped in a hellish rotation: binging, purging, binging, purging. According to the DSM 5, this binge-purge cycle must occur once a week for 3 months or more to be diagnosed with Bulimia nervosa.
Recently, experts have been diagnosing many adolescents with “binge eating disorder,” which is identical to Bulimia except without the guilty need to compensate for the outrageous amount of calories consumed.
We have come up with creative ways to make toddlers eat unfamiliar foods: cutting foods into fun shapes, making airplanes sounds as you spoon it in, or even making a game out of the meal. Yet, when adolescents and adults refuse food in the same way as children, comparatively, finding techniques to help encourage eating is incredibly difficult.
The next, Avoidant/Restrictive Food Intake Disorder, or AN/BN describes someone with little interest in food or nutrition. They also show no concern for their weight. As a result, significant weight loss, nutritional deficiency, and psychological impairment occur, typically requiring alternate feeding to sustain the patient. Without the proper balance of nutrients, a human body cannot support its major functions and is prone to failure and illness.
Most common within the autistic community, patients refuse to eat because of sensory issues, whether that be the temperature, color, or texture many avoid certain food groups entirely.
“I have an 8th grade patient who heard in class that sugar is poison, and refuses to eat anything that may involve it.” Cody said that many people develop this disorder after a traumatic event. Those who have nearly died choking fear choking again and may need to be tube fed until professionals can work through their anxiety of eating.
Overall Avoidant/Restrictive Food Intake Disorder is a powerful eating disorder that can take years of treatment to overcome. Many of its patients must learn to manage their cognitive, or mental, disabilities before facing AN/BN.
Notoriously known as the “wastebasket” eating disorder, OSFED or Other Specified Feeding and Eating Disorders, takes the stage as our last opponent. Being a conglomerate of subcategories, medical professionals are now able prescribe patients for their less than ordinary conditions - something they couldn’t do a few years ago.
Within OSFED, Purging Disorder is Bulimia nervosa without the binge. Some compensation mechanisms include self-induced vomiting or chewing food but spitting it out afterward. Atypical anorexia is Anorexia nervosa’s twin, yet somehow the victim manages to maintain a normal weight.
Subthreshold bulimia entails the same behaviors of Bulimia but at a lower frequency. Subthreshold binge eating disorder resembles binge eating disorder, but also occurs at a lower frequency.
OSFED may come in many forms, but there is one subcategory in particular -- Night Eating Syndrome -- that mystifies the public and has the media exploding, as it is becoming more commonly diagnosed.
Victims of Night Eating Syndrome are tormented by severe cases of food-related insomnia. Differing from any nocturnal sleep-related eating disorder, where the victim is sleeping while eating, those with Night Eating Syndrome are unable to fall asleep without having eaten the majority of their calories before bed.
Many are awakened during sleep and cannot return to bed without eating. Unfortunately, this disorder affects the body’s circadian rhythms, a 24-hour cycle that tells our bodies when to sleep and regulates many other physiological processes. This adds significant stress to the victim’s daily life – reducing their immune system’s ability to fight illness and increasing the risk for chronic heart disease.
“Similar to my husband, an upward of 40% of people seeking gastric bypass surgery will qualify for this eating disorder.”
Cody says that like Night Eating Syndrome, questionnaires are available to patients who show concern about harboring a possible eating disorder. A series of psychological and physiological evaluations will ensue if the questionnaire raises any red flags.
Some immediate signals of a possible eating disorder are fear of gaining weight, or the desire to count calories, fat or protein excessively. If an individual eats any taboo foods (beyond cultural delicacies), follows strange food rules, constantly weighs themselves, or has an outrageous goal weight, are also reasons for concern.
Anorexia, Bulimia, Binge Eating, AN/BN and OFSED include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders cause life-threatening emotional and physical problems that cannot be addressed without a team of professionals.
“Despite everyone telling them how sick they are, they deny the seriousness of their low weight.” Cody concludes. “Everyone feels pressure to look a certain way. That can be terrifying for adolescents and young adults.”
But if we know the warning signs, understand the difference between eating disorders, and reach out to our loved ones who suffer – together we can save lives worldwide.
